How is Post-Traumatic Stress Disorder in a Chronic Pelvic Pain Population Associated with Altered Surgical Outcome?

Background: The link between post-traumatic stress disorder (PTSD) and chronic pain conditions, specifically pelvic pain, has long been established. Within a chronic pelvic pain (CPP) population, the prevalence of PTSD is 31%, compared with 10% of women in the general population. In this group, the diagnosis of PTSD is usually associated with exposure to sexual and physical abuse. CPP is known to be a difficult diagnosis, in that many patients are refractory to treatment or suffer relapses. Meanwhile, PTSD alone is associated with overall poorer health outcomes. However, there is limited information on how pre-existing PTSD affects CPP in regards to treatment outcomes and disease trajectory. Objective: To determine if a diagnosis of PTSD is associated with differences in long-term pain outcomes among a CPP population treated with surgery

Genitofemoral and Perineal Neuralgia After Transobturator Midurethral Sling

Midurethral slings successfully treat stress urinary incontinence through a minimally invasive vaginal approach. Postoperative pain related to sling placement can occur and poses both diagnostic and treatment dilemmas

Dorsal clitoral nerve injury following transobturator midurethral sling

Transobturator slings can be successfully used to treat stress urinary incontinence and improve quality of life through a minimally invasive vaginal approach. Persistent postoperative pain can occur and pose diagnostic and therapeutic dilemmas. Following a sling procedure, a patient complained of pinching clitoral and perineal pain. Her symptoms of localized clitoral pinching and pain became generalized over the ensuing years, eventually encompassing the entire left vulvovaginal region

Overlap Between Orofacial Pain and Vulvar Vestibulitis Syndrome

To explore the prevalence of Orofacial Pain (OFP) among patients with Vulvar Vestibulitis Syndrome (VVS) and to examine the relationship between signs and symptoms of OFP and clinical characteristics of women with VVS; we specifically sought to investigate differences in psychological characteristics and self-reported severity of painful intercourse

Altered Central Sensitization in Subgroups of Women With Vulvodynia

To investigate the clinical correlates of central nervous system (CNS) alterations among women with vulvodynia. Altered central sensitization has been linked to dysfunction in CNS inhibitory pathways (e.g. GABAergic), and metrics of sensory adaptation, a centrally mediated process that is sensitive to this dysfunction, could potentially be used to identify women at risk of treatment failure using conventional approaches

Somatization and psychological distress among women with vulvar vestibulitis syndrome

ObjectiveTo investigate the distribution of psychological characteristics and pain reporting among women with vulvar vestibulitis syndrome (VVS).MethodsIn this exploratory study, 109 women with VVS completed a battery of questionnaires to assess pain with intercourse and psychological characteristics (e.g. somatization, anxiety, distress). The distribution of these characteristics was compared, first with a conventional binary classification schema (primary and secondary) and subsequently with a 3â category schema (primary, latent primary, secondary).ResultsSeverity of pain with intercourse did not differ among the subgroups using either classification schema. Women with primary VVS consistently showed higher levels of somatization, anxiety, and distress compared with those with secondary VVS. Using a 3â tiered classification system, we found no difference between latent primary diagnosis and the other 2 groups (primary and secondary).ConclusionThis study highlights the critical need for research on subtype definition and the role of psychological factors in VVS.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135448/1/ijgo38.pd

Genitofemoral and Perineal Neuralgia After Transobturator Midurethral Sling

BACKGROUND: Midurethral slings successfully treat stress urinary incontinence through a minimally invasive vaginal approach. Postoperative pain related to sling placement can occur and poses both diagnostic and treatment dilemmas. CASE: Four years after transobturator midurethral sling placement, the patient presented with complaints of left labial pain and dyspareunia since surgery. Using sensory mapping and a nerve stimulator, the problem was identified in the distribution of the genitofemoral nerve. Conservative therapy with a centrally acting neuromodulatory drug and nerve block relieved the pain. CONCLUSION: Postsling neuralgia diagnosis using sensory mapping and a nerve stimulator aids in indentifying the nerve involved and in successful conservative treatment with a nerve block